公开(公告)号：US20090306737A1

公开(公告)日：2009-12-10

申请号：US12540902

申请日：2009-08-13

申请人： Geng Zhang ,  Ankur Garg ,  Douglas R. Daum

发明人： Geng Zhang ,  Ankur Garg ,  Douglas R. Daum

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/3622 ,  A61N1/3714

摘要： Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient's heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response.

摘要翻译： 描述了用于将心脏反应分类为起搏刺激和/或预防逆行心脏传导的方法和系统。 在心脏周期内将起搏脉搏递送到患者心脏的心房后，系统在心房感测逆行P波。 该系统基于逆行P波的检测将起搏脉冲的心房响应分类。 该系统还可以感知心房诱发反应并且利用心房诱发反应来分类心脏起搏反应。

公开(公告)号：US07606616B2

公开(公告)日：2009-10-20

申请号：US11276530

申请日：2006-03-03

申请人： Douglas R. Daum ,  Quan Ni

发明人： Douglas R. Daum ,  Quan Ni

IPC分类号： A61N1/365

CPC分类号： A61N1/365

摘要： Calibration of adaptive-rate pacing by a cardiac rhythm management system using an intrinsic chronotropic response. The cardiac rhythm management system may include an adaptive-rate pacing device. The adaptive-rate pacing device may include an adaptive-rate sensor module for measuring an activity level of the individual. A monitor module may be coupled to the adaptive-rate sensor module, the monitor module monitoring an intrinsic chronotropic response. A calculator module may be coupled to the monitor module, the calculator module calculating a calibrated parameter for the adaptive-rate pacing device based on the intrinsic chronotropic response. An adjuster module may be coupled to the calculator module, wherein the adjuster module adjusts the adaptive-rate pacing device based on the calibrated parameter. The parameters of the adaptive-rate pacing device adjusted by the adjuster module may include a sensor rate target, a maximum sensor rate, and a response factor.

摘要翻译： 使用内在的时间延迟响应通过心律管理系统校准自适应起搏。 心律管理系统可以包括自适应速率起搏装置。 自适应速率起搏装置可以包括用于测量个人的活动水平的自适应速率传感器模块。 监视器模块可以耦合到自适应速率传感器模块，监视器模块监视固有的时间变化响应。 计算器模块可以耦合到监视器模块，计算器模块基于固有的时间变化响应来计算自适应速率起搏装置的校准参数。 调节器模块可以耦合到计算器模块，其中调节器模块基于校准参数来调整自适应速率起搏装置。 由调节器模块调整的自适应速率起搏装置的参数可以包括传感器速率目标，最大传感器速率和响应因子。

公开(公告)号：US07551962B2

公开(公告)日：2009-06-23

申请号：US11071984

申请日：2005-03-04

申请人： Douglas R. Daum ,  Qingsheng Zhu ,  Bruce H. KenKnight

发明人： Douglas R. Daum ,  Qingsheng Zhu ,  Bruce H. KenKnight

IPC分类号： A61N1/362

CPC分类号： A61N1/37217 ,  A61N1/3625 ,  A61N1/3627 ,  A61N1/37247

摘要： An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of receiving communications in the form of speech spoken by the patient. An acoustic transducer is incorporated within the device which along with associated filtering circuitry enables the voice communication to be used to affect the operation of the device or recorded for later playback.

公开(公告)号：US06684101B2

公开(公告)日：2004-01-27

申请号：US09843112

申请日：2001-04-25

申请人： Douglas R. Daum

发明人： Douglas R. Daum

IPC分类号： A61B505

CPC分类号： A61N1/36521

摘要： A method and system is implemented in an implantable medical device (IMD) and provides for the detection of multiple physiologic parameters in response to a single source current event. A high frequency source current signal is propagated through body tissues in the thorax, including the heart. The source current signal has a frequency greater than a frequency of a pacing current signal producible by the IMD. In response to the source current signal, a first voltage is detected between two portions of a first region of the heart substantially concurrently with sensing a second voltage between one of the IMD housing and a header/can electrode and one of the two portions of the first region of the heart. The first voltage is associated with a cardiac function and the second voltage is indicative of a respiratory function. The source current signal may be a single or multiple cycle current pulse. The source current signal may also be a continuous current signal. The source current signal may take the form of a monophasic current pulse or have a polyphasic character, such as in the case of a biphasic current pulse.

摘要翻译： 在可植入医疗装置（IMD）中实现了一种方法和系统，并且响应于单个源电流事件提供了多个生理参数的检测。 高频源电流信号通过胸部的身体组织传播，包括心脏。 源电流信号的频率大于IMD可产生的起搏电流信号的频率。 响应于源电流信号，在心脏的第一区域的两个部分之间基本同时检测第一电压，以感测IMD壳体和头/罐电极之一之间的第二电压和 心脏的第一个区域。 第一电压与心脏功能相关联，第二电压指示呼吸功能。 源电流信号可以是单周期或多周期电流脉冲。 源电流信号也可以是连续电流信号。 源电流信号可以采取单相电流脉冲的形式或具有多相字符，例如在双相电流脉冲的情况下。

公开(公告)号：US08532771B2

公开(公告)日：2013-09-10

申请号：US13115825

申请日：2011-05-25

申请人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio C. Spinelli

发明人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio C. Spinelli

IPC分类号： A61N1/365

CPC分类号： A61N1/365

摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

摘要翻译： 与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。 最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。 最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。 在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率 到起搏器。

公开(公告)号：US08224445B2

公开(公告)日：2012-07-17

申请号：US13205387

申请日：2011-08-08

申请人： Geng Zhang ,  Douglas R. Daum ,  James O. Gilkerson ,  Quan Ni

发明人： Geng Zhang ,  Douglas R. Daum ,  James O. Gilkerson ,  Quan Ni

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3621 ,  A61N1/3756

摘要： An implantable pacemaker is provided with a far-field sensing channel which requires a reduced refractory period during the time when pacing pulses are delivered as compared with sensing channels using intra-cardiac electrodes. The far-field sensing channel may use the conductive housing of the implantable device or can and an indifferent electrode mounted on the device header as the electrodes for its differential inputs. Such a far-field sensing channel is able to sense activity occurring in either the atria or the ventricles for the purposes of arrhythmia detection and/or capture verification.

摘要翻译： 植入式心脏起搏器设置有远场感测通道，与使用心脏内电极的感测通道相比，在进行起搏脉冲的时间期间需要减少的不应期。 远场感测通道可以使用可植入装置的导电外壳或者可以将安装在设备头上的无关电极用作其差分输入的电极。 为了心律失常检测和/或捕获验证的目的，这种远场感测通道能够感测在心房或心室中发生的活动。

公开(公告)号：US08078276B2

公开(公告)日：2011-12-13

申请号：US12494628

申请日：2009-06-30

申请人： Yanting Dong ,  Jiang Ding ,  Douglas R. Daum ,  Scott A. Meyer ,  Yinghong Yu

发明人： Yanting Dong ,  Jiang Ding ,  Douglas R. Daum ,  Scott A. Meyer ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/371

摘要： A method and system for determining an optimum atrioventricular delay (AVD) interval and/or ventriculo-ventricular delay (VVD) intervals for delivering ventricular resynchronization pacing in an atrial tracking or atrial sequential pacing mode. Evoked response electrograms recorded at different AVD and VVD intervals are used to determine the extent of paced and intrinsic activation.

摘要翻译： 一种用于确定用于在心房跟踪或心房顺序起搏模式中递送心室再同步起搏的最佳房室延迟（AVD）间隔和/或心室 - 心室延迟（VVD）间隔的方法和系统。 以不同的AVD和VVD间隔记录的诱发反应电图用于确定起搏和内在激活的程度。

公开(公告)号：US07996083B2

公开(公告)日：2011-08-09

申请号：US10858848

申请日：2004-06-02

申请人： Geng Zhang ,  Douglas R. Daum ,  James O. Gilkerson ,  Quan Ni

发明人： Geng Zhang ,  Douglas R. Daum ,  James O. Gilkerson ,  Quan Ni

IPC分类号： A61N1/368

CPC分类号： A61N1/371 ,  A61N1/3621 ,  A61N1/3756

摘要： An implantable pacemaker is provided with a far-field sensing channel which requires a reduced refractory period during the time when pacing pulses are delivered as compared with sensing channels using intra-cardiac electrodes. The far-field sensing channel may use the conductive housing of the implantable device or can and an indifferent electrode mounted on the device header as the electrodes for its differential inputs. Such a far-field sensing channel is able to sense activity occurring in either the atria or the ventricles for the purposes of arrhythmia detection and/or capture verification.

摘要翻译： 植入式心脏起搏器设置有远场感测通道，与使用心脏内电极的感测通道相比，在进行起搏脉冲的时间期间需要减少的不应期。 远场感测通道可以使用可植入装置的导电外壳或者可以将安装在设备头上的无关电极用作其差分输入的电极。 为了心律失常检测和/或捕获验证的目的，这种远场感测通道能够感测在心房或心室中发生的活动。

公开(公告)号：US07720541B2

公开(公告)日：2010-05-18

申请号：US10643203

申请日：2003-08-18

申请人： Jeffrey E. Stahmann ,  John D. Hatlestad ,  Quan Ni ,  Jesse Hartley ,  Douglas R. Daum ,  Kent Lee

发明人： Jeffrey E. Stahmann ,  John D. Hatlestad ,  Quan Ni ,  Jesse Hartley ,  Douglas R. Daum ,  Kent Lee

IPC分类号： A61N1/00

CPC分类号： A61N1/362 ,  A61N1/3601

摘要： An approach to providing disordered breathing therapy includes detecting disordered breathing and adapting a therapy to mitigate the disordered breathing. The therapy may be adapted to enhance therapy effectiveness, to provide therapy that reduces an impact of the therapy on the patient, or to achieve other therapeutic goals. Cardiac electrical therapy to mitigate the disordered breathing may include various cardiac pacing regimens and/or delivery of non-excitatory electrical stimulation to the heart.

摘要翻译： 提供无序呼吸治疗的方法包括检测无序呼吸并适应治疗以减轻无序呼吸。 治疗可以适应于增强治疗有效性，提供减少治疗对患者的影响或实现其它治疗目标的治疗。 减轻无序呼吸的心脏电疗可能包括各种心脏起搏方案和/或向心脏递送非兴奋性电刺激。

公开(公告)号：US07706866B2

公开(公告)日：2010-04-27

申请号：US10876008

申请日：2004-06-24

申请人： Yi Zhang ,  Marina Brockway ,  Carlos Alberto Ricci ,  Ron Heil ,  Douglas R. Daum ,  Robert J. Sweeney ,  Aaron McCabe

发明人： Yi Zhang ,  Marina Brockway ,  Carlos Alberto Ricci ,  Ron Heil ,  Douglas R. Daum ,  Robert J. Sweeney ,  Aaron McCabe

IPC分类号： A61B5/04

CPC分类号： A61B5/0006 ,  A61B5/0031 ,  A61B5/04011 ,  A61B5/0422 ,  A61B5/7207 ,  A61B5/7217 ,  A61N1/3756 ,  G06K9/624

摘要： Cardiac monitoring and/or stimulation methods and systems provide monitoring, defibrillation and/or pacing therapies. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal using a source separation algorithm, and identifies a cardiac signal using a selected vector. The signal processor may iteratively separate signals from the plurality of composite signals until the cardiac signal is identified. The selected vector may be updated if desired or necessary. A method of signal separation involves detecting a plurality of composite signals at a plurality of locations, separating a signal using source separation, and selecting a vector that provides a cardiac signal. The separation may include a principal component analysis and/or an independent component analysis. Vectors may be selected and updated based on changes of position and/or orientation of implanted components and changes in patient parameters such as patient condition, cardiac signal-to-noise ratio, and disease progression.

摘要翻译： 心脏监测和/或刺激方法和系统提供监测，除颤和/或起搏治疗。 信号处理器接收与多个源相关联的多个复合信号，使用源分离算法分离信号，并使用所选择的向量来识别心脏信号。 信号处理器可以迭代地分离来自多个复合信号的信号，直到识别出心脏信号。 如果需要或必要，可以更新所选择的向量。 信号分离的方法包括在多个位置检测多个复合信号，使用源分离分离信号，以及选择提供心脏信号的向量。 分离可以包括主成分分析和/或独立成分分析。 可以基于植入组件的位置和/或取向的改变以及患者参数（例如患者状况，心脏信噪比和疾病进展）的变化来选择和更新载体。